Step #1: Registration Form

Name

Instructor and dates of retreat

Email*

Phone (prefer # used during travel)*

City, State & Zip*

Date of Birth*

Gender*

Nationality of Passport*

Departure Airport*

Occupancy: DOUBLE or SINGLE (For double, list roommate name and shared or separate bed arrangement)*

Mat Rental: YES OR NO ($35 for Manduka Pro mat rental)*

Dietary restrictions (List any dietary restrictions and/or allergies)

How did you hear about this retreat?

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Step #2: Place Deposit

$495 non-refundable deposit will reserve your space.
Full payment is due 4 months prior to the retreat.

US: 812-783-9642 Belize: +501-637-4109